Monday, January 4, 2016

old school: Lows vs. Highs

I didn't think lows vs. highs were a thing until I had a few comments back in response to my post on D-hacks.

First, since I know I have a few readers not completely consumed with diabetes like myself and other T1's, let me explain:

I will assume you already understand the basics of keeping blood sugar in a very unrealistic margin. Ergo, many highs and many lows will inevitably ensue. Lows are a result of too much insulin and not enough glucose. The wee brain runs exclusively on glucose so a lack of that in the body causes the brain to have a temper tantrum and start shutting down some pretty important systems that keep our body alive. Often it's from too much insulin injected probably due to miscalculation of carbs consumed (or not eating what I originally planned to). Or too much exercise and not enough fuelage (read:carbs). I'll just leave it at those two main culprits.

Highs on the other hand are the opposite. Too little insulin and and too much glucose running amok in the body. Either from eating too much and not taking enough insulin or countless other bullshit reasons. ie:hormones, stress, sick, blue skies etc.

Lows and Highs happen. Sometimes a lot. Hour to hour, day to day.

Why I would always prefer to be low rather than high is complicated I'm beginning to realize. It's deeply ingrained in my psyche also. A low usually comes on hard and fast. It requires fast acting carbs like glucose tabs to correct it. It kinda feels like you're dying. Brain temper tantrum remember? It's a fight or flight response to lack of glucose so it's kind of terrifying. That is, if you aren't used to it. MOST lows are corrected in less than 20 minutes after consuming sugar. If left untreated, one goes into insulin shock resulting in a seizure of sorts and then possible coma. When treated...on with the day. Unless you're me and sugar upsets your stomach most of the time. That's irrelevant to this topic though. Point is, they come on like a tornado causing immediate flight or fight response. Some glucose and a few minutes of being collapsed over, life goes on. They look really bad from the outside and they feel even worse from the inside.

Highs. Highs are motherfucking assholes. Look at it this way; the range of blood glucose is as such: Under 4mmol/l is low. Above 7mmol/l is high. There's not much farther to go below 4. However there is a shit ton above 7mmol/l!!! Like between 7 and over 30. Blood sugar doesn't rise noticeably as fast. It's not until it's above that tipping point (everybody is different) before one notices it. It's simply an over-abundance of glucose. The only way to get it back down is more insulin. (I only WISH it was more cowbell) Or exercise if that's a possibility. I often feel so ick that I can hardly move. Depending on the severity of the high it could take a couple hours which feels like an eternity.

Therein lies the rub for me.
Lows are fixed in a few minutes comparatively speaking. Sure they feel like death, BUT, they are quickly remedied. Highs are my nemesis. Your Diabetes May Vary! I feel icky at about 13. I start getting tired and unbelievably cranky and bitchy (just ask Ryan). At 15+ my stomach hurts. Its a pain I've never been able to describe. It feels like all the blank space between my organs are being pulled and tightened which double me over in a ball. At 18+ the indescribable nausea hits along with the pain. My eyelids become stone and my breathing gets laboured. I haven't been above 20 in years but it's the super danger zone. The worst part about this is by the time I know I'm that high it's already too late. The insulins we have available to us these days just aren't fast enough. Even an injection of fast acting won't start working for at least an hour. So by the time I realize I'm high and inject, I know I'm going to go even higher. It always gets worse before it gets better. It often takes 2-3 hours for me to get back in range. Most people complain of being incessantly thirsty but I am so nauseated and headachey that I can't even swallow anything. Yes, there is the inhale-able insulin that works wonders in a fraction of the time but it's just not available in Canada yet. Maybe next millennium.

Then there's the psychological aspect of being high. I know I'm stuck there for hours. What damage is happening inside my body being this high for that many hours? I panic. I freak out. I'm learning to force calmness on myself knowing it will help reduce the stress and cortisol output which only persist the highs even more. But inside I'm scared of causing permanent damage. At least with a low I've never passed out or gone into insulin shock. I've never been hospitalized or ever used glucagon. Sure I've been low enough to warrant it but I've always taken care of it myself. Even the worst lows that leave me deathly hungover for a day are more tolerable than hours of being so high that I am a bitch on wheels.

So there you have it. Why I'll take a low over a high any day!

And why I chronically over-dose as a result.


  1. When you wrote about this earlier, you made me think. So - I'm working at trying not to be high, even if it means I take the chance of being low. I hate, hate, hate waiting for a high to just go away.

  2. I used to be the opposite, being deathly afraid of lows but recently I changed my mind and prefer to treat a low than deal with a high. Go figure ;)


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